改良无抽搐电休克疗法对难治性抑郁症(TRD)患者认知功能的影响与安全性分析

Analysis of Effect of Modified Electric Convulsive Therapy on the Cognitive Function of Patients with Treatment Resistant Depression and Safety

目的探讨改良无抽搐电休克疗法(MECT)对难治性抑郁症(TRD)患者的认知功能的影响与安全性。方法选取该院在2014年4月—2015年4月收治的50例TRD患者,对患者进行MECT治疗,治疗前及治疗6次后均采用汉密尔顿抑郁量表(HAMD)对抑郁程度进行评价;采用威斯康辛卡片检测患者的言语流畅程度、数字广度和数学符号、汉诺塔、连线检测AB,评定患者认知功能;采用副反应量表(TESS)来评定患者的不良反应。结果经过MECT的6次治疗,患者的HAMD平均分为由(22.59±7.16)分变为(7.67±2.17)分,治疗前后对比差异有统计学意义(P<0.05);治疗前各项认知功能为(27.45±15.84)分,明显低于治疗后的(34.28±15.20)分(P<0.05)。结论 MECT对TRD患者的认知功能改善和抑郁程度控制有较好的效果,且没有不良反应,较为安全,临床上具有使用价值。

Objective To discuss the effect of modified electric convulsive therapy on the cognitive function of patients with treatment resistant depression and safety. Methods 50 cases of TRD patients admitted and treated in our hospital from April 2014 to April 2015 were selected and treated with MECT, and the depression degree was evaluated by the HAMD before treatment and after 6 treatment, and the verbal fluency, numerical span, mathematical symbol, tower of Hanoi and ligature of patients were tested by the Wisconsin Card, and the cognitive function was evaluated, and the adverse reactions of patients were evaluated by the TESS. Results After 6 treatment of MECT, the average score of HAMD of patients changed from(22.59±7.16)points to(7.67±2.17)points, and the difference before and after treatment was obvious(P<0.05), and various cognitive functions before treatment was obviously lower than that after treatment,[(27.45±15.84)scores vs(34.28±15.20)points](P<0.05). Conclusion The improvement effect of cognitive function and depression degree of MECT for TRD patients is good without adverse reactions, and it is safe and is of application value in clinic.